Brandon Regional Hospital
persistent atrial fibrillation, peAF, fibrotic atrial myopathy, ablation
Cardiology | Cardiovascular Diseases
Introduction | Objectives: Ablation of persistent atrial fibrillation (peAF) is associated with a worse outcome. Fibrotic atrial myopathy (FAM) is thought to play a role in the progression of AF. Estimation of left atrial voltage can vary significantly based on whether mapping is performed in fibrillatory conduction or sinus rhythm (SR). Selection of a voltage scale (VS) may lead to an over/under estimation of FAM. We determined the prevalence of advanced atrial myopathy (FAM > = 2) in SR compared to historical cohort ablated in peAF.
Methods: A homogenous group of peAF patients who underwent ablation in SR following cardioversion were analyzed, followed prospectively. There were no significant differences in clinical covariates compared to a historical cohort of peAF. For uniformity the Arruda scale of 0.1‐0.5 mV was used for the VS (CARTO‐Biosense Webster, USA). The lesion set was primarily WACA ± posterior box for both groups
Results: 26 patients were followed prospectively and compared to 54 historical peAF patients. There was no statistical difference in the major clinical variables between both groups (Figure 1). The historical cohort 74% [95% CI, 60 to 85] had FAM > = 2, while the SR group exhibited 62% [95% CI, 41 to 80]. There was no difference in clinical outcome achieving SR with 80% and 81% for the historical and study groups (P = 0.89).
Conclusions: Preliminary data would suggest that mapping either in AF or SR is acceptable for determining the extent of FAM in this population to guide a substrate‐based ablation strategy.
Publisher or Conference
25th Annual International Atrial Fibrillation Symposium
Goldgrab D, Kalaveshi S, Henao J, et al. AFS‐22 Ablation of persistent atrial fibrillation substrate in sinus rhythm does not lead to an overestimation of fibrotic atrial myopathy: A Pilot Study. Poster presented at the 25th Annual International Atrial Fibrillation Symposium; January 23-25, 2020; Washington D.C.